Streets of terraced stone houses in Hebden bridge, Calderdale.
Defeating COVID-19 involves everyone working together at local and national level.
Since July, 100 local authorities have worked in partnership with NHS Test and Trace to provide local tracing partnerships which combine national scale and data with local knowledge.
Calderdale Council was one of the first local authorities to launch a local tracing partnership with NHS Test and Trace. Deborah Harkins, Calderdale’s Director of Public Health, discusses how it is working in the area:
“In Calderdale, we have been working with NHS Test and Trace for some time to develop a local tracing partnership and we’re improving it day-by-day. When the opportunity first arose in the summer to work with government to develop local contact tracing we were absolutely delighted to get on board.
“Contact tracing is a critical part of the prevention and control of COVID-19. It needs to work hand in hand with other measures, such as limiting social contact, engaging with communities and groups at high risk of getting COVID-19 because of their working and living conditions, preventing COVID-19 taking hold in care homes and enforcing restrictions.
“Test and Trace allows us to find people who have the virus and those they may have infected. Once identified, we can advise them to isolate therefore breaking the chain of infection. We can also support them to complete the self-isolation period including making those who are eligible aware of the new financial support grant.
“We also recognise the criticality of this local tracing partnership and that it is giving us really helpful local information about how people are being exposed to the virus, and this is continuously informing our approaches to containing the virus.
“We have seen some real benefits of the local, regional and national services working together. I believe this is critical for NHS Test and Trace to work as effectively as possible. I think that’s the case across the country given that 100 local authorities have also launched a localised model in partnership with the national programme. In Calderdale we recruited and redeployed people to be trained as local contact tracers. They are people who know and are trusted by our local communities. A number of our local contact tracers can speak community languages.
“Local tracing partnerships involve our staff on the ground working with a dedicated team of contact tracers from NHS Test and Trace who support all the local authorities taking part, to help reach as many people as possible who have tested positive for coronavirus. If the dedicated Test and Trace team is unable to make contact with a local resident within 24 hours, our local public health officials and other colleagues follow up.
“We receive information about people living in Calderdale who have tested positive and those that have not been reached by the national Test and Trace Service due to calls not being responded to are passed to us within 24 hours to ensure we work collectively to reach as many people as possible. Our role is to speak to them and gather information about the people they may have infected based on agreed criteria about when they were infectious and how close they were to them and for how long. The people they may have infected are called contacts.
“Our team of local contact tracers use text messages, telephone and home visits to contact the COVID case to identify people they may have infected and to offer support with self-isolation.
“During September, the Calderdale local contact tracing service received details of 213 Calderdale cases out of the 697 number of total cases that were handled by Test and Trace. Of the 213, 86% were contacted and completed by local contact tracers. 9% could not be reached, 4% refused to provide details (because they had finished their isolation period) and one person had sadly died. We were then able to pass back to Test and Trace the details of their respective contacts for the contact tracing to continue.
“For those we are not able to reach there is almost always a good reason, such as they are in hospital or we’ve been unable to get the right contact details, which is why our combined efforts are so critical.
“We have also started to visit cases where the information given by the individual on the phone was not detailed enough to allow us to carry out the contact tracing we need. This is working particularly well in Calderdale. We have some people who have provided more detailed information when speaking face to face and have been much more receptive once they’re aware of the support available to them.
“The pandemic can be a very stressful time for people, especially for those who are at risk. Nevertheless, we have found that our local contact tracers are almost always well received in Calderdale including when they visit people at home.”
The local tracing partnership with Calderdale has complemented the national system’s capacity and access to data thanks to the local teams’ insight. There have already been notable examples of where the local contact tracers have been able to use their local expertise to identify possible routes of transmission and outbreaks. These have included possible links through sports clubs, car sharing and workplaces, which can be shared with Test and Trace as part of the wider national analysis.
“Stopping these potential outbreaks is clear evidence that by combining our local knowledge with the data and resources of NHS Test and Trace, we can ensure we contact as many people as possible, as quickly as possible. It is a combination of national scale, data and expertise with our unique local “boots on the ground” insight in order to tackle the pandemic.
“In another instance, intelligence gained by local contact tracers led us to identify a business proprietor who had provided inaccurate information about when staff had worked in an apparent attempt to stop the outbreak being detected and to keep his business operating. By contact tracers speaking to a number of cases who appeared to be linked to the business, they were able to gather the full facts and identify the potential workplace transmission. This enabled us to use enforcement powers to close the business and reduce the risk of future transmission.
“Over time, local tracing partnerships will provide extra insight into specific ways transmission is happening throughout the country. This information will help inform local measures to contain and prevent the spread. The unique local knowledge of local teams, coupled with vast experience of contact tracing within local public health teams, is vital in working with NHS Test and Trace.”
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Contributor: Deborah Harkins